Community Hospital of Staunton
Community Hospital of Staunton in Staunton, IL publishes cash prices for 263 common procedures listed here, from its own machine-readable price file updated Feb 9, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Illinois median for 199 of 263 procedures and above it for 62. By typical cash price it ranks #25 of 90 Illinois hospitals and #3 of 15 hospitals in the St. Louis, MO area, cheapest first. Click a procedure to compare it with other hospitals nearby.
400 North Caldwell Street, Staunton, IL 62088-1173 Collected Sep 27, 2026 Source price file (618) 635-2200
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 141306 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3+VIEWS | $221.60 | $443.20 | $128.13–$500.00 | 33% below | 50% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3+VIEWS | $221.60 | $443.20 | $376.72–$403.31 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ART DOP W/ PRESSURE 1 EXT | $409.50 | $819.00 | $236.79–$745.29 | 2% above | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ARTERIAL ANKLE/BRACHIAL IND | $409.50 | $819.00 | $236.79–$745.29 | 2% above | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ART DOP W/ PRESSURE 1 EXT | $409.50 | $819.00 | $696.15–$745.29 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ARTERIAL ANKLE/BRACHIAL IND | $409.50 | $819.00 | $696.15–$745.29 | — | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM | $341.30 | $682.60 | $197.35–$621.17 | 37% below | 50% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM | $341.30 | $682.60 | $580.21–$621.17 | — | 50% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN-WHOLE BODY | $966.05 | $1,932.10 | $558.61–$1,943.00 | 37% below | 50% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN-WHOLE BODY | $966.05 | $1,932.10 | $1,642.28–$1,758.21 | — | 50% |
| Breast ultrasound, complete, one breast CPT 76641 US BREAST COMPLETE BIL | $188.55 | $377.10 | $109.02–$1,018.00 | 57% below | 50% |
| Breast ultrasound, complete, one breast CPT 76641 US BREAST COMPLETE | $307.50 | $615.00 | $177.81–$1,018.00 | 30% below | 50% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST COMPLETE BIL | $188.55 | $377.10 | $320.54–$343.16 | — | 50% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST COMPLETE | $307.50 | $615.00 | $522.75–$559.65 | — | 50% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED | $112.55 | $225.10 | $65.08–$1,018.00 | 70% below | 50% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED BIL | $225.05 | $450.10 | $130.13–$1,018.00 | 39% below | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED | $112.55 | $225.10 | $191.33–$204.84 | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED BIL | $225.05 | $450.10 | $382.58–$409.59 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/ | $1,710.30 | $3,420.60 | $988.97–$3,112.75 | 26% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/ | $1,710.30 | $3,420.60 | $2,907.51–$3,112.75 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O | $1,968.60 | $3,937.20 | $1,138.33–$3,582.85 | 35% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O | $1,968.60 | $3,937.20 | $3,346.62–$3,582.85 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/ | $2,532.80 | $5,065.60 | $1,464.57–$4,609.70 | 26% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/ | $2,532.80 | $5,065.60 | $4,305.76–$4,609.70 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD AND PELVIS W/WO | $2,757.25 | $5,514.50 | $1,594.35–$5,018.20 | 36% below | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD AND PELVIS W/WO | $2,757.25 | $5,514.50 | $4,687.32–$5,018.20 | — | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ | $1,512.65 | $3,025.30 | $874.68–$2,959.00 | 24% below | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ | $1,512.65 | $3,025.30 | $2,571.50–$2,753.02 | — | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O | $1,170.70 | $2,341.40 | $676.94–$2,959.00 | 28% below | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O | $1,170.70 | $2,341.40 | $1,990.19–$2,130.67 | — | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O | $1,071.65 | $2,143.30 | $619.67–$2,959.00 | 25% below | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O | $1,071.65 | $2,143.30 | $1,821.80–$1,950.40 | — | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN W/O | $1,071.65 | $2,143.30 | $619.67–$2,959.00 | 32% below | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN W/O | $1,071.65 | $2,143.30 | $1,821.80–$1,950.40 | — | 50% |
| CT scan of the head with contrast CPT 70460 CT BRAIN W/ | $1,196.05 | $2,392.10 | $691.61–$2,959.00 | 26% below | 50% |
| CT scan of the head with contrast inpatient CPT 70460 CT BRAIN W/ | $1,196.05 | $2,392.10 | $2,033.28–$2,176.81 | — | 50% |
| CT scan of the head without and with contrast CPT 70470 CT BRAIN W/WO | $1,514.80 | $3,029.60 | $875.92–$2,959.00 | 29% below | 50% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN W/WO | $1,514.80 | $3,029.60 | $2,575.16–$2,756.94 | — | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O | $1,118.00 | $2,236.00 | $646.48–$2,959.00 | 43% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O | $1,118.00 | $2,236.00 | $1,900.60–$2,034.76 | — | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O | $1,273.45 | $2,546.90 | $736.36–$2,959.00 | 36% below | 50% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O | $1,273.45 | $2,546.90 | $2,164.87–$2,317.68 | — | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ | $1,319.20 | $2,638.40 | $762.81–$2,959.00 | 28% below | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ | $1,319.20 | $2,638.40 | $2,242.64–$2,400.94 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DUPLEX -BIL | $651.45 | $1,302.90 | $376.69–$1,185.64 | 13% below | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DUPLEX -BIL | $651.45 | $1,302.90 | $1,107.47–$1,185.64 | — | 50% |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS | $253.25 | $506.50 | $146.44–$500.00 | 11% below | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS | $253.25 | $506.50 | $430.52–$460.92 | — | 50% |
| Chest X-ray, single view CPT 71045 CHEST-DECUBITIS-BIL | $39.45 | $78.90 | $22.81–$500.00 | 83% below | 50% |
| Chest X-ray, single view CPT 71045 CXR-CHEST TUBE INSERT/POS | $218.50 | $437.00 | $126.34–$500.00 | 7% below | 50% |
| Chest X-ray, single view CPT 71045 CHEST-ONE VIEW | $221.60 | $443.20 | $128.13–$500.00 | 6% below | 50% |
| Chest X-ray, single view inpatient CPT 71045 CHEST-DECUBITIS-BIL | $39.45 | $78.90 | $67.06–$71.80 | — | 50% |
| Chest X-ray, single view inpatient CPT 71045 CXR-CHEST TUBE INSERT/POS | $218.50 | $437.00 | $371.45–$397.67 | — | 50% |
| Chest X-ray, single view inpatient CPT 71045 CHEST-ONE VIEW | $221.60 | $443.20 | $376.72–$403.31 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE | $580.50 | $1,161.00 | $335.67–$1,056.51 | 26% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE | $580.50 | $1,161.00 | $986.85–$1,056.51 | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA BONE DENISTY AXIAL | $292.00 | $584.00 | $168.84–$531.44 | 31% below | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA BONE DENISTY AXIAL | $292.00 | $584.00 | $496.40–$531.44 | — | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA BONE DENSITY EXTREMITY | $140.75 | $281.50 | $81.39–$500.00 | 39% below | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA BONE DENSITY EXTREMITY | $140.75 | $281.50 | $239.28–$256.17 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST DIAGNOSTIC W/O | $1,020.10 | $2,040.20 | $589.86–$2,959.00 | 18% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST DIAGNOSTIC W/O | $1,020.10 | $2,040.20 | $1,734.17–$1,856.58 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST DIAGNOSTIC W/ | $1,196.05 | $2,392.10 | $691.61–$2,959.00 | 41% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST DIAGNOSTIC W/ | $1,196.05 | $2,392.10 | $2,033.28–$2,176.81 | — | 50% |
| Diagnostic mammogram, both breasts CPT 77066 POST BIOPSY DIAG MAM - BIL | $276.80 | $553.60 | $160.05–$503.78 | 3% below | 50% |
| Diagnostic mammogram, both breasts CPT 77066 DIGITAL MAM DIAG - BIL | $395.45 | $790.90 | $228.66–$719.72 | 38% above | 50% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 POST BIOPSY DIAG MAM - BIL | $276.80 | $553.60 | $470.56–$503.78 | — | 50% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 DIGITAL MAM DIAG - BIL | $395.45 | $790.90 | $672.26–$719.72 | — | 50% |
| Diagnostic mammogram, one breast CPT 77065 MAM DIAG | $216.70 | $433.40 | $125.30–$394.39 | 23% below | 50% |
| Diagnostic mammogram, one breast CPT 77065 POST BIOPSY DIAG MAM | $270.90 | $541.80 | $156.64–$493.04 | 4% below | 50% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAM DIAG | $216.70 | $433.40 | $368.39–$394.39 | — | 50% |
| Diagnostic mammogram, one breast inpatient CPT 77065 POST BIOPSY DIAG MAM | $270.90 | $541.80 | $460.53–$493.04 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US ARTERIAL DUPLEX LOWER BIL | $544.55 | $1,089.10 | $314.88–$991.08 | 42% below | 50% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US ARTERIAL DUPLEX LOWER BIL | $544.55 | $1,089.10 | $925.73–$991.08 | — | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US DUPLEX EXTREMITY VEIN BIL | $844.30 | $1,688.60 | $488.21–$1,536.63 | 45% below | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US DUPLEX EXTREMITY VEIN BIL | $844.30 | $1,688.60 | $1,435.31–$1,536.63 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO-CARD DOPPLER-COLOR FLOW | $1,547.80 | $3,095.60 | $895.00–$2,817.00 | 14% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO-CARD DOPPLER-COLOR FLOW | $1,547.80 | $3,095.60 | $2,631.26–$2,817.00 | — | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATO GB/EF WITH ENSURE | $1,512.65 | $3,025.30 | $874.68–$2,753.02 | 18% above | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATO GB/EF WITH ENSURE | $1,512.65 | $3,025.30 | $2,571.50–$2,753.02 | — | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 UNATTEND SLEEP <4 HRS/TECH | $227.95 | $455.90 | $131.81–$414.87 | 72% below | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 UNATTENDED SLEEP STUDY | $1,234.95 | $2,469.90 | $714.10–$2,247.61 | 52% above | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 UNATTEND SLEEP <4 HRS/TECH | $227.95 | $455.90 | $387.52–$414.87 | — | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 UNATTENDED SLEEP STUDY | $1,234.95 | $2,469.90 | $2,099.42–$2,247.61 | — | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 CPAP TITRATION ROOM/TECH <4hr | $3,175.35 | $6,350.70 | $1,836.12–$5,779.14 | 3% below | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SPLIT NIGHT SLEEP STUDY/CPAP | $4,232.65 | $8,465.30 | $2,447.49–$7,703.42 | 29% above | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 CPAP TITRATION ROOM/TECH <4hr | $3,175.35 | $6,350.70 | $5,398.09–$5,779.14 | — | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SPLIT NIGHT SLEEP STUDY/CPAP | $4,232.65 | $8,465.30 | $7,195.50–$7,703.42 | — | 50% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS | $221.60 | $443.20 | $128.13–$500.00 | 33% below | 50% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS | $221.60 | $443.20 | $376.72–$403.31 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED | $580.50 | $1,161.00 | $335.67–$1,056.51 | 1% above | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SOFT TISSUE LOWER BACK | $580.50 | $1,161.00 | $335.67–$1,056.51 | 1% above | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SOFT TISSUE LOWER BACK | $580.50 | $1,161.00 | $986.85–$1,056.51 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED | $580.50 | $1,161.00 | $986.85–$1,056.51 | — | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LDCT LUNG CANCER SCREENING | $1,020.10 | $2,040.20 | $589.86–$2,959.00 | 87% above | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LDCT LUNG CANCER SCREENING | $1,020.10 | $2,040.20 | $1,734.17–$1,856.58 | — | 50% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI BREAST BIL-W/WO W/CAD | $548.90 | $1,097.80 | $317.39–$999.00 | 70% below | 50% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI BREAST BIL-W/WO W/CAD | $548.90 | $1,097.80 | $933.13–$999.00 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXT W JNT WO | $1,670.95 | $3,341.90 | $966.21–$3,041.13 | 31% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXT W JNT WO | $1,670.95 | $3,341.90 | $2,840.62–$3,041.13 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT W JNT W/WO | $2,185.25 | $4,370.50 | $1,263.60–$3,977.16 | 32% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXT W JNT W/WO | $2,185.25 | $4,370.50 | $3,714.92–$3,977.16 | — | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O | $1,758.85 | $3,517.70 | $1,017.04–$3,201.11 | 15% below | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O | $1,758.85 | $3,517.70 | $2,990.04–$3,201.11 | — | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO | $2,251.35 | $4,502.70 | $1,301.82–$4,097.46 | 27% below | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO | $2,251.35 | $4,502.70 | $3,827.29–$4,097.46 | — | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN/BRAIN STEM W/O | $1,659.00 | $3,318.00 | $959.30–$3,019.38 | 24% below | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN/BRAIN STEM W/O | $1,659.00 | $3,318.00 | $2,820.30–$3,019.38 | — | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN/BRAIN STEM W/WO | $2,275.95 | $4,551.90 | $1,316.05–$4,142.23 | 30% below | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN/BRAIN STEM W/WO | $2,275.95 | $4,551.90 | $3,869.12–$4,142.23 | — | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O | $1,758.85 | $3,517.70 | $1,017.04–$3,201.11 | 31% below | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O | $1,758.85 | $3,517.70 | $2,990.04–$3,201.11 | — | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/WO | $2,251.35 | $4,502.70 | $1,301.82–$4,097.46 | 31% below | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/WO | $2,251.35 | $4,502.70 | $3,827.29–$4,097.46 | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE W/O | $1,527.55 | $3,055.10 | $883.29–$2,780.14 | 40% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE W/O | $1,527.55 | $3,055.10 | $2,596.84–$2,780.14 | — | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE W/WO | $1,932.70 | $3,865.40 | $1,117.56–$3,517.51 | 40% below | 50% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE W/WO | $1,932.70 | $3,865.40 | $3,285.59–$3,517.51 | — | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE W/O | $1,712.45 | $3,424.90 | $990.21–$3,116.66 | 25% below | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE W/O | $1,712.45 | $3,424.90 | $2,911.16–$3,116.66 | — | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO | $2,208.45 | $4,416.90 | $1,277.02–$4,019.38 | 21% below | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO | $2,208.45 | $4,416.90 | $3,754.36–$4,019.38 | — | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O | $1,153.85 | $2,307.70 | $667.20–$2,100.01 | 46% below | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O | $1,153.85 | $2,307.70 | $1,961.54–$2,100.01 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT W JNT WO | $1,643.50 | $3,287.00 | $950.34–$2,991.17 | 36% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT W JNT WO | $1,643.50 | $3,287.00 | $2,793.95–$2,991.17 | — | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERF SPECT-MULTI | $2,935.20 | $5,870.40 | $1,732.94–$5,752.99 | 9% below | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERF SPECT-MULTI | $2,935.20 | $5,870.40 | $4,989.84–$5,342.06 | — | 50% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT-SKULL BASE TO MID THIGH | $2,217.00 | $4,434.00 | $1,308.92–$4,345.32 | 60% below | 50% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT-SKULL BASE TO MID THIGH | $2,217.00 | $4,434.00 | $3,768.90–$4,034.94 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NON OB LIMITED | $281.45 | $562.90 | $162.75–$1,018.00 | 34% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NON OB LIMITED | $281.45 | $562.90 | $478.46–$512.24 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NON OB COMPLETE | $545.30 | $1,090.60 | $315.31–$1,018.00 | 13% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NON OB COMPLETE | $545.30 | $1,090.60 | $927.01–$992.45 | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >14WKS | $527.70 | $1,055.40 | $311.55–$1,034.29 | 13% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB >14WKS | $527.70 | $1,055.40 | $897.09–$960.41 | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <14WKS | $434.10 | $868.20 | $256.29–$1,018.00 | 22% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB <14WKS | $434.10 | $868.20 | $737.97–$790.06 | — | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OBSTERICAL LIMITED | $138.85 | $277.70 | $81.98–$1,018.00 | 66% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OBSTERICAL LIMITED | $138.85 | $277.70 | $236.04–$252.71 | — | 50% |
| Screening mammogram, both breasts CPT 77067 DIGITAL MAM SCREEN - BIL | $395.45 | $790.90 | $80.88–$719.72 | 49% above | 50% |
| Screening mammogram, both breasts one side CPT 77067 DIGITAL MAM SCREEN UNILATERAL | $270.90 | $541.80 | $80.88–$493.04 | 2% above | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 DIGITAL MAM SCREEN - BIL | $395.45 | $790.90 | $672.26–$719.72 | — | 50% |
| Screening mammogram, both breasts inpatient one side CPT 77067 DIGITAL MAM SCREEN UNILATERAL | $270.90 | $541.80 | $460.53–$493.04 | — | 50% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER 2+ VIEWS | $221.60 | $443.20 | $128.13–$500.00 | 31% below | 50% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER 2+ VIEWS | $221.60 | $443.20 | $376.72–$403.31 | — | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY ROOM/TECH <6HR | $2,865.30 | $5,730.60 | $1,656.84–$5,214.85 | 3% below | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY (SLEEP STUDY) | $3,819.50 | $7,639.00 | $2,208.60–$6,951.49 | 30% above | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY ROOM/TECH <6HR | $2,865.30 | $5,730.60 | $4,871.01–$5,214.85 | — | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY (SLEEP STUDY) | $3,819.50 | $7,639.00 | $6,493.15–$6,951.49 | — | 50% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE | $387.05 | $774.10 | $223.81–$704.43 | 72% below | 50% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 TRANSTHORAC ECHO WITH CONTRAST | $2,269.00 | $4,538.00 | $1,312.03–$4,129.58 | 67% above | 50% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMPLETE | $387.05 | $774.10 | $657.98–$704.43 | — | 50% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 TRANSTHORAC ECHO WITH CONTRAST | $2,269.00 | $4,538.00 | $3,857.30–$4,129.58 | — | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB | $443.25 | $886.50 | $256.31–$1,018.00 | 19% below | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB | $443.25 | $886.50 | $753.52–$806.72 | — | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL | $404.60 | $809.20 | $238.88–$1,018.00 | 14% below | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL | $404.60 | $809.20 | $687.82–$736.37 | — | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE | $629.70 | $1,259.40 | $364.12–$1,146.05 | 35% below | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE | $629.70 | $1,259.40 | $1,070.49–$1,146.05 | — | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM | $580.50 | $1,161.00 | $342.73–$1,056.51 | 12% below | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM | $580.50 | $1,161.00 | $986.85–$1,056.51 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TIS/HEAD/NECK/THYROID | $452.45 | $904.90 | $261.62–$1,018.00 | 26% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TIS/HEAD/NECK/THYROID | $452.45 | $904.90 | $769.16–$823.46 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI WO/ KUB | $431.90 | $863.80 | $249.74–$786.06 | 20% below | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI WO/ KUB | $431.90 | $863.80 | $734.23–$786.06 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US DUPLEX EXTREMITY VEIN LTD | $506.65 | $1,013.30 | $292.96–$922.10 | 20% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US DUPLEX EXTREMITY VEIN LTD | $506.65 | $1,013.30 | $861.30–$922.10 | — | 50% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST 3+ VIEWS | $261.15 | $522.30 | $151.01–$500.00 | 16% below | 50% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST 3+ VIEWS | $261.15 | $522.30 | $443.95–$475.29 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP2-3 VWS UNI | $235.80 | $471.60 | $136.35–$500.00 | 14% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP 2-3 VWS W/PELIS UNI | $235.80 | $471.60 | $136.35–$500.00 | 14% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP2-3 VWS UNI | $235.80 | $471.60 | $400.86–$429.16 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP 2-3 VWS W/PELIS UNI | $235.80 | $471.60 | $400.86–$429.16 | — | 50% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW | $221.60 | $443.20 | $128.13–$500.00 | 15% below | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW | $221.60 | $443.20 | $376.72–$403.31 | — | 50% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS | $199.80 | $399.60 | $115.53–$500.00 | 29% below | 50% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS | $199.80 | $399.60 | $339.66–$363.64 | — | 50% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGER(S) 2+VIEWS | $189.95 | $379.90 | $109.84–$500.00 | 21% below | 50% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER(S) 2+VIEWS | $189.95 | $379.90 | $322.91–$345.71 | — | 50% |
| X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS | $221.60 | $443.20 | $128.13–$500.00 | 16% below | 50% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2 VIEWS | $221.60 | $443.20 | $376.72–$403.31 | — | 50% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3+ VIEWS | $221.60 | $443.20 | $128.13–$500.00 | 31% below | 50% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3+ VIEWS | $221.60 | $443.20 | $376.72–$403.31 | — | 50% |
| X-ray of the hand, 3 or more views CPT 73130 HAND 3+ VIEWS | $221.60 | $443.20 | $128.13–$500.00 | 32% below | 50% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND 3+ VIEWS | $221.60 | $443.20 | $376.72–$403.31 | — | 50% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1-2 VIEWS | $205.40 | $410.80 | $118.77–$500.00 | 24% below | 50% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1-2 VIEWS | $205.40 | $410.80 | $349.18–$373.83 | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2-3 VIEWS | $228.00 | $456.00 | $131.84–$500.00 | 43% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2-3 VIEWS | $228.00 | $456.00 | $387.60–$414.96 | — | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE 4+ VIEWS | $369.40 | $738.80 | $213.60–$672.31 | 30% below | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE 4+ VIEWS | $369.40 | $738.80 | $627.98–$672.31 | — | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS | $89.90 | $179.80 | $51.98–$500.00 | 75% below | 50% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEWS | $89.90 | $179.80 | $152.83–$163.62 | — | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES-3+VIEWS | $211.05 | $422.10 | $122.04–$500.00 | 27% below | 50% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES-3+VIEWS | $211.05 | $422.10 | $358.78–$384.11 | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE-2 - 3 VIEWS | $211.05 | $422.10 | $122.04–$500.00 | 36% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE-2 - 3 VIEWS | $211.05 | $422.10 | $358.78–$384.11 | — | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 VIEWS | $221.60 | $443.20 | $128.13–$500.00 | 31% below | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEWS | $221.60 | $443.20 | $376.72–$403.31 | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX ONE VIEW | $49.40 | $98.80 | $28.57–$500.00 | 83% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX 2+ VIEWS | $253.25 | $506.50 | $146.44–$500.00 | 11% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM/COCCYX ONE VIEW | $49.40 | $98.80 | $83.98–$89.91 | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM/COCCYX 2+ VIEWS | $253.25 | $506.50 | $430.52–$460.92 | — | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT | $57.65 | $115.30 | $33.34–$104.92 | 10% above | 50% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT | $57.65 | $115.30 | $98.00–$104.92 | — | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT | $62.70 | $125.40 | $36.26–$114.11 | 19% above | 50% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT | $62.70 | $125.40 | $106.59–$114.11 | — | 50% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL A B C GROUP | $207.60 | $415.20 | $96.00–$377.83 | 14% below | 50% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL A B C GROUP | $207.60 | $415.20 | $352.92–$377.83 | — | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE | $52.75 | $105.50 | $30.50–$96.01 | 92% above | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE | $52.75 | $105.50 | $89.68–$96.01 | — | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 C1 ESTERASE INHIBITOR | $112.55 | $225.10 | $65.08–$204.84 | 34% above | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 C1 ESTERASE INHIBITOR | $112.55 | $225.10 | $191.33–$204.84 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $88.00 | $176.00 | $50.88–$160.16 | 2% below | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP B-TYPE NATRIURETIC PEPTID | $166.05 | $332.10 | $96.00–$302.21 | 3% below | 50% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP B-TYPE NATRIURETIC PEPTID | $166.05 | $332.10 | $282.29–$302.21 | — | 50% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $126.65 | $253.30 | $73.24–$230.50 | 1% below | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $126.65 | $253.30 | $215.30–$230.50 | — | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE LEVEL 4 GROSS & MICRO | $193.50 | $387.00 | $111.89–$352.17 | 19% below | 50% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE LEVEL 4 GROSS & MICRO | $193.50 | $387.00 | $328.95–$352.17 | — | 50% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $123.15 | $246.30 | $71.21–$224.13 | 18% below | 50% |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE | $123.15 | $246.30 | $209.36–$224.13 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 LAB DRAW SEND VENI CHARGE | $12.20 | $24.40 | $7.06–$96.00 | 46% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE CHARGE | $14.80 | $29.60 | $8.56–$96.00 | 34% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LAB DRAW SEND VENI CHARGE | $12.20 | $24.40 | $20.74–$22.20 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE CHARGE | $14.80 | $29.60 | $25.16–$26.94 | — | 50% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD QUANT | $56.30 | $112.60 | $32.56–$102.47 | 71% above | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD QUANT | $56.30 | $112.60 | $95.71–$102.47 | — | 50% |
| Blood lead test CPT 83655 LEAD LEVEL | $109.05 | $218.10 | $63.05–$198.47 | 90% above | 50% |
| Blood lead test inpatient CPT 83655 LEAD LEVEL | $109.05 | $218.10 | $185.38–$198.47 | — | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST | $60.50 | $121.00 | $34.99–$110.11 | 16% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST | $60.50 | $121.00 | $102.85–$110.11 | — | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE | $35.20 | $70.40 | $20.35–$96.00 | 57% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE | $35.20 | $70.40 | $59.84–$64.06 | — | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $57.65 | $115.30 | $33.34–$104.92 | 15% below | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN | $57.65 | $115.30 | $98.00–$104.92 | — | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $161.30 | $322.60 | $93.27–$293.57 | 13% below | 50% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE | $161.30 | $322.60 | $274.21–$293.57 | — | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA19-9 | $123.15 | $246.30 | $71.21–$224.13 | 17% above | 50% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA19-9 | $123.15 | $246.30 | $209.36–$224.13 | — | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $129.45 | $258.90 | $74.85–$235.60 | 17% below | 50% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $129.45 | $258.90 | $220.06–$235.60 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019-NCOV OTHER DX PANEL | $167.55 | $335.10 | $96.00–$304.94 | 67% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019-NCOV OTHER DX PANEL | $167.55 | $335.10 | $284.84–$304.94 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY DNA AMPLIFIED | $164.60 | $329.20 | $95.18–$299.57 | 24% above | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY DNA AMPLIFIED | $164.60 | $329.20 | $279.82–$299.57 | — | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $147.80 | $295.60 | $85.47–$269.00 | 33% above | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE | $147.80 | $295.60 | $251.26–$269.00 | — | 50% |
| Complete blood count (CBC) with differential CPT 85025 CHARGE FOR AUTO DIFF | $85.20 | $170.40 | $49.26–$155.06 | 9% above | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CHARGE FOR AUTO DIFF | $85.20 | $170.40 | $144.84–$155.06 | — | 50% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $62.70 | $125.40 | $36.26–$114.11 | 2% below | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM | $62.70 | $125.40 | $106.59–$114.11 | — | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $154.75 | $309.50 | $89.48–$281.64 | 3% above | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $154.75 | $309.50 | $263.08–$281.64 | — | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE SULFATE | $144.90 | $289.80 | $83.79–$263.72 | 35% above | 50% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE SULFATE | $144.90 | $289.80 | $246.33–$263.72 | — | 50% |
| Estradiol blood test CPT 82670 ULTRA SENSITIVE ESTRADIOL | $112.55 | $225.10 | $65.08–$204.84 | 6% above | 50% |
| Estradiol blood test inpatient CPT 82670 ULTRA SENSITIVE ESTRADIOL | $112.55 | $225.10 | $191.33–$204.84 | — | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE | $180.10 | $360.20 | $96.00–$327.78 | 57% above | 50% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE | $180.10 | $360.20 | $306.17–$327.78 | — | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN (STOOL) | $186.45 | $372.90 | $96.00–$339.34 | 10% above | 50% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN (STOOL) | $186.45 | $372.90 | $316.96–$339.34 | — | 50% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $88.60 | $177.20 | $51.23–$161.25 | 31% below | 50% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $88.60 | $177.20 | $150.62–$161.25 | — | 50% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $89.40 | $178.80 | $51.70–$162.71 | 14% below | 50% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $89.40 | $178.80 | $151.98–$162.71 | — | 50% |
| Free T3 thyroid hormone test CPT 84481 FREE T3 | $92.80 | $185.60 | $53.66–$168.90 | 1% below | 50% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 | $92.80 | $185.60 | $157.76–$168.90 | — | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $80.20 | $160.40 | $46.37–$145.96 | 30% below | 50% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 | $80.20 | $160.40 | $136.34–$145.96 | — | 50% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $112.55 | $225.10 | $65.08–$204.84 | 8% below | 50% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE | $112.55 | $225.10 | $191.33–$204.84 | — | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPECIMENS | $130.15 | $260.30 | $75.25–$236.87 | 4% above | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 SPECIMENS | $130.15 | $260.30 | $221.26–$236.87 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY DNA AMPLIFIED | $158.35 | $316.70 | $91.56–$288.20 | 12% above | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC BY DNA AMPLIFIED | $158.35 | $316.70 | $269.20–$288.20 | — | 50% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG | $97.05 | $194.10 | $56.11–$176.63 | at median | 50% |
| H. pylori stool antigen test inpatient CPT 87338 HPYLORI STOOL AG | $97.05 | $194.10 | $164.98–$176.63 | — | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV I RNA QUANTITATIVE PCR ULT | $408.75 | $817.50 | $96.00–$743.92 | 36% above | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV I RNA QUANTITATIVE PCR ULT | $408.75 | $817.50 | $694.88–$743.92 | — | 50% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 AND/OR HIV-2 AB SC | $158.15 | $316.30 | $91.45–$287.83 | 32% above | 50% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1 AND/OR HIV-2 AB SC | $158.15 | $316.30 | $268.86–$287.83 | — | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 Ag W/HIV-1 & HIV-2 AB | $91.45 | $182.90 | $52.88–$166.44 | 19% below | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 Ag W/HIV-1 & HIV-2 AB | $91.45 | $182.90 | $155.46–$166.44 | — | 50% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV (CERVISTA) TP VIAL (SEMC) | $113.30 | $226.60 | $66.62–$222.07 | 23% below | 50% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV (CERVISTA) TP VIAL (SEMC) | $113.30 | $226.60 | $192.61–$206.21 | — | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $88.00 | $176.00 | $50.88–$160.16 | 8% above | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY | $78.85 | $157.70 | $45.59–$143.51 | 8% below | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY | $78.85 | $157.70 | $134.04–$143.51 | — | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN | $75.30 | $150.60 | $43.54–$137.05 | 6% below | 50% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN | $75.30 | $150.60 | $128.01–$137.05 | — | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS ANTIBODY | $92.25 | $184.50 | $53.34–$167.90 | 15% below | 50% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS ANTIBODY | $92.25 | $184.50 | $156.82–$167.90 | — | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA BY PCR | $209.60 | $419.20 | $96.00–$381.47 | 16% below | 50% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA BY PCR | $209.60 | $419.20 | $356.32–$381.47 | — | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 SPECIFIC ANTIBODY | $88.00 | $176.00 | $50.88–$160.16 | 35% above | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 SPECIFIC ANTIBODY | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 SPECIFIC ANTIBODY | $123.15 | $246.30 | $71.21–$224.13 | 37% above | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 SPECIFIC ANTIBODY | $123.15 | $246.30 | $209.36–$224.13 | — | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $76.70 | $153.40 | $44.35–$139.59 | 14% below | 50% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HS | $76.70 | $153.40 | $130.39–$139.59 | — | 50% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE CARDIOVASCULAR | $182.95 | $365.90 | $96.00–$332.97 | 74% above | 50% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE CARDIOVASCULAR | $182.95 | $365.90 | $311.02–$332.97 | — | 50% |
| Insulin blood test CPT 83525 INSULIN | $92.25 | $184.50 | $53.34–$167.90 | 27% above | 50% |
| Insulin blood test inpatient CPT 83525 INSULIN | $92.25 | $184.50 | $156.82–$167.90 | — | 50% |
| Iron blood test (serum iron) CPT 83540 IRON | $65.45 | $130.90 | $37.85–$119.12 | 11% below | 50% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $65.45 | $130.90 | $111.26–$119.12 | — | 50% |
| Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY | $80.20 | $160.40 | $46.37–$145.96 | 17% above | 50% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY | $80.20 | $160.40 | $136.34–$145.96 | — | 50% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $123.80 | $247.60 | $71.59–$225.32 | 14% below | 50% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $123.80 | $247.60 | $210.46–$225.32 | — | 50% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE | $129.45 | $258.90 | $74.85–$235.60 | 36% above | 50% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE | $129.45 | $258.90 | $220.06–$235.60 | — | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $70.40 | $140.80 | $40.71–$128.13 | 12% below | 50% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE | $70.40 | $140.80 | $119.68–$128.13 | — | 50% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $144.30 | $288.60 | $83.44–$262.63 | 20% above | 50% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $144.30 | $288.60 | $245.31–$262.63 | — | 50% |
| Lyme disease antibody test CPT 86618 LYME DISEASE | $111.15 | $222.30 | $64.27–$202.29 | 57% above | 50% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE | $111.15 | $222.30 | $188.96–$202.29 | — | 50% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL | $63.30 | $126.60 | $36.60–$115.21 | 11% below | 50% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM LEVEL | $63.30 | $126.60 | $107.61–$115.21 | — | 50% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA (MEASLES) IGG | $92.25 | $184.50 | $53.34–$167.90 | 27% above | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA (MEASLES) IGG | $92.25 | $184.50 | $156.82–$167.90 | — | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONOTEST | $54.90 | $109.80 | $31.74–$99.92 | 24% below | 50% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOTEST | $54.90 | $109.80 | $93.33–$99.92 | — | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA | $123.15 | $246.30 | $72.41–$224.13 | 20% above | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA | $123.15 | $246.30 | $209.36–$224.13 | — | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN SCR | $123.15 | $246.30 | $72.41–$224.13 | 15% above | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 TOTAL DIAGNOSTIC PSA | $123.15 | $246.30 | $72.41–$224.13 | 15% above | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 TOTAL DIAGNOSTIC PSA | $123.15 | $246.30 | $209.36–$224.13 | — | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN SCR | $123.15 | $246.30 | $209.36–$224.13 | — | 50% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP TEST-THIN PREP | $129.45 | $258.90 | $74.85–$235.60 | 4% below | 50% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP TEST-THIN PREP | $129.45 | $258.90 | $220.06–$235.60 | — | 50% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP | $123.15 | $246.30 | $71.21–$224.13 | 12% above | 50% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP | $123.15 | $246.30 | $209.36–$224.13 | — | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE N-TERMINAL | $88.00 | $176.00 | $50.88–$160.16 | 60% below | 50% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE N-TERMINAL | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME | $59.10 | $118.20 | $34.17–$107.56 | 7% above | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME | $59.10 | $118.20 | $100.47–$107.56 | — | 50% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY | $1,761.15 | $3,522.30 | $96.00–$3,451.86 | 129% above | 50% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHRMOML ANEUPLOIDY | $1,761.15 | $3,522.30 | $2,993.96–$3,205.29 | — | 50% |
| Progesterone blood test CPT 84144 PROGESTERONE LEVEL | $129.45 | $258.90 | $74.85–$235.60 | 2% below | 50% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE LEVEL | $129.45 | $258.90 | $220.06–$235.60 | — | 50% |
| Prolactin blood test CPT 84146 PROLACTIN | $98.50 | $197.00 | $56.96–$179.27 | 15% below | 50% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $98.50 | $197.00 | $167.45–$179.27 | — | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME PROFILE | $54.20 | $108.40 | $31.34–$98.64 | 74% above | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME PROFILE | $54.20 | $108.40 | $92.14–$98.64 | — | 50% |
| Rapid flu test (influenza antigen) CPT 87804 INFECTIOUS AG DIRECT OBS FLU | $92.25 | $184.50 | $53.34–$167.90 | 62% above | 50% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFECTIOUS AG DIRECT OBS FLU | $92.25 | $184.50 | $156.82–$167.90 | — | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP-DIRECT ANTIGEN GRP A | $70.40 | $140.80 | $40.71–$128.13 | 29% above | 50% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP-DIRECT ANTIGEN GRP A | $70.40 | $140.80 | $119.68–$128.13 | — | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR TITRE | $63.30 | $126.60 | $36.60–$115.21 | 19% above | 50% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR TITRE | $63.30 | $126.60 | $107.61–$115.21 | — | 50% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $87.85 | $175.70 | $50.80–$159.89 | 15% above | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY | $87.85 | $175.70 | $149.34–$159.89 | — | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 WESTERGREN SED RATE | $5.30 | $10.60 | $3.07–$96.00 | 88% below | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 WESTERGREN SED RATE | $5.30 | $10.60 | $9.01–$9.65 | — | 50% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANAL VAL/COUNT/MOT | $107.20 | $214.40 | $61.98–$195.10 | 7% below | 50% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANAL VAL/COUNT/MOT | $107.20 | $214.40 | $182.24–$195.10 | — | 50% |
| Stool ova and parasites exam CPT 87177 CONCENTRATION | $69.00 | $138.00 | $39.90–$125.58 | 6% below | 50% |
| Stool ova and parasites exam inpatient CPT 87177 CONCENTRATION | $69.00 | $138.00 | $117.30–$125.58 | — | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD FECES CONSECUTIVE | $35.20 | $70.40 | $20.35–$96.00 | 36% above | 50% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLD FECES CONSECUTIVE | $35.20 | $70.40 | $59.84–$64.06 | — | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLOOD IMMUNOASSAY | $88.00 | $176.00 | $50.88–$160.16 | 19% above | 50% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL OCCULT BLOOD IMMUNOASSAY | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $52.75 | $105.50 | $30.50–$96.01 | 3% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL | $52.75 | $105.50 | $89.68–$96.01 | — | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GAMMA INTERFERON AG RESPONS | $206.20 | $412.40 | $96.00–$375.28 | 11% below | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB GAMMA INTERFERON AG RESPONS | $206.20 | $412.40 | $350.54–$375.28 | — | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $126.65 | $253.30 | $73.24–$230.50 | 1% above | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL | $126.65 | $253.30 | $215.30–$230.50 | — | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $128.05 | $256.10 | $74.04–$233.05 | 42% above | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH | $128.05 | $256.10 | $217.68–$233.05 | — | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATED HORMONE | $96.80 | $193.60 | $55.98–$176.18 | 26% below | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATED HORMONE | $96.80 | $193.60 | $164.56–$176.18 | — | 50% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS AMPLIFICATION | $140.75 | $281.50 | $81.39–$256.17 | 13% above | 50% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS AMPLIFICATION | $140.75 | $281.50 | $239.28–$256.17 | — | 50% |
| Uric acid blood test CPT 84550 URIC ACID | $55.70 | $111.40 | $32.21–$101.37 | 21% below | 50% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $55.70 | $111.40 | $94.69–$101.37 | — | 50% |
| Urinalysis with microscope exam, automated CPT 81001 URINE WITH MICROSCOPIC | $52.10 | $104.20 | $30.13–$96.00 | 13% below | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINE WITH MICROSCOPIC | $52.10 | $104.20 | $88.57–$94.82 | — | 50% |
| Urinalysis without microscope exam, automated CPT 81003 UA W/O MICROSCOPY AUTOMATED | $24.55 | $49.10 | $14.20–$96.00 | 37% above | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA W/O MICROSCOPY AUTOMATED | $24.55 | $49.10 | $41.74–$44.68 | — | 50% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS - NON AUTOMATED | $14.10 | $28.20 | $8.15–$96.00 | 42% below | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS - NON AUTOMATED | $14.10 | $28.20 | $23.97–$25.66 | — | 50% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE | $70.40 | $140.80 | $40.71–$128.13 | 21% below | 50% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE | $70.40 | $140.80 | $119.68–$128.13 | — | 50% |
| Urine pregnancy test, read by color change CPT 81025 BEDSIDE-URINE PREGNANCY TEST | $69.65 | $139.30 | $40.28–$126.76 | 3% above | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 BEDSIDE-URINE PREGNANCY TEST | $69.65 | $139.30 | $118.40–$126.76 | — | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B 12 | $84.40 | $168.80 | $48.80–$153.61 | 33% below | 50% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B 12 | $84.40 | $168.80 | $143.48–$153.61 | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $144.30 | $288.60 | $83.44–$262.63 | 23% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY | $144.30 | $288.60 | $245.31–$262.63 | — | 50% |
| Zinc blood test CPT 84630 ZINC | $88.00 | $176.00 | $50.88–$160.16 | 41% above | 50% |
| Zinc blood test inpatient CPT 84630 ZINC | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT | $126.65 | $253.30 | $73.24–$230.50 | 21% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT | $126.65 | $253.30 | $215.30–$230.50 | — | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CL TX METATARSAL FX WO MANIP | $110.55 | $221.10 | $63.93–$201.20 | 83% below | 50% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CL TX METATARSAL FX WO MANIP | $110.55 | $221.10 | $187.94–$201.20 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION | $479.85 | $959.70 | $277.47–$7,400.00 | 58% below | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION | $479.85 | $959.70 | $815.74–$873.33 | — | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOV MPAC CERU IRRIG/LAVA UNL | $84.40 | $168.80 | $48.80–$153.61 | 26% below | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 RMVL IMPACTED CERUMEN BIL | $126.40 | $252.80 | $73.09–$230.05 | 11% above | 50% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOV MPAC CERU IRRIG/LAVA UNL | $84.40 | $168.80 | $143.48–$153.61 | — | 50% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 RMVL IMPACTED CERUMEN BIL | $126.40 | $252.80 | $214.88–$230.05 | — | 50% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN UNI | $105.60 | $211.20 | $61.06–$192.19 | 16% below | 50% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX BIL | $179.10 | $358.20 | $103.57–$325.96 | 43% above | 50% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN UNI | $105.60 | $211.20 | $179.52–$192.19 | — | 50% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX BIL | $179.10 | $358.20 | $304.47–$325.96 | — | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INTRODUCE HYSTERO CATHETER | $273.35 | $546.70 | $158.06–$7,400.00 | 12% below | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INTRODUCE HYSTERO CATHETER | $273.35 | $546.70 | $464.70–$497.50 | — | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SKIN ABSCS SIMPLE/SINGLE | $228.70 | $457.40 | $132.24–$416.23 | 43% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE | $251.30 | $502.60 | $145.31–$457.37 | 38% below | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SKIN ABSCS SIMPLE/SINGLE | $228.70 | $457.40 | $388.79–$416.23 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE | $251.30 | $502.60 | $427.21–$457.37 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJCTION SNGLE TNDN LIGMNT UNI | $90.25 | $180.50 | $52.19–$164.26 | 76% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJCTION SNGLE TNDN LIGMNT UNI | $90.25 | $180.50 | $153.42–$164.26 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 LG JOINT INJ/ASP ADD | $83.40 | $166.80 | $48.23–$151.79 | 81% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRAT LG JT HIP KNEE SHOULDR | $187.05 | $374.10 | $108.16–$340.43 | 58% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 LARGE JNT ASPRTION/INJECT UNI | $246.30 | $492.60 | $142.42–$448.27 | 45% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 LG JOINT INJ/ASP ADD | $83.40 | $166.80 | $141.78–$151.79 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRAT LG JT HIP KNEE SHOULDR | $187.05 | $374.10 | $317.98–$340.43 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 LARGE JNT ASPRTION/INJECT UNI | $246.30 | $492.60 | $418.71–$448.27 | — | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 MD JOINT INJ/ASP ADD | $85.75 | $171.50 | $49.59–$156.06 | 77% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIR MED JT WRIST ELBOW ANKLE | $167.55 | $335.10 | $96.88–$304.94 | 56% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 MEDIUM JNT ASPRTION/INJCT UNI | $246.30 | $492.60 | $142.42–$448.27 | 35% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 MD JOINT INJ/ASP ADD | $85.75 | $171.50 | $145.78–$156.06 | — | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIR MED JT WRIST ELBOW ANKLE | $167.55 | $335.10 | $284.84–$304.94 | — | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 MEDIUM JNT ASPRTION/INJCT UNI | $246.30 | $492.60 | $418.71–$448.27 | — | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 SM JOINT INJ/ASP ADD | $83.15 | $166.30 | $48.08–$151.33 | 72% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRAT SMALL JT FINGERS TOES | $246.30 | $492.60 | $142.42–$448.27 | 17% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 SMALL JNT ASPRATION/INJCT UNI | $246.30 | $492.60 | $142.42–$448.27 | 17% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 SM JOINT INJ/ASP ADD | $83.15 | $166.30 | $141.36–$151.33 | — | 50% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 SMALL JNT ASPRATION/INJCT UNI | $246.30 | $492.60 | $418.71–$448.27 | — | 50% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRAT SMALL JT FINGERS TOES | $246.30 | $492.60 | $418.71–$448.27 | — | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMDRPR 2.5CM OR < SATE | $263.85 | $527.70 | $152.57–$480.21 | 56% below | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMDRPR 2.5CM OR < SATE | $263.85 | $527.70 | $448.54–$480.21 | — | 50% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE | $88.00 | $176.00 | $50.88–$160.16 | 70% below | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS WITH IMAGE | $313.05 | $626.10 | $181.02–$569.75 | 77% below | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS WITH IMAGE | $313.05 | $626.10 | $532.19–$569.75 | — | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL | $211.05 | $422.10 | $122.04–$384.11 | 60% below | 50% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL | $211.05 | $422.10 | $358.78–$384.11 | — | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE FB SUBQ SIMPLE | $185.05 | $370.10 | $107.01–$336.79 | 60% below | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FB SUBQ SIMPLE | $185.05 | $370.10 | $314.59–$336.79 | — | 50% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT SHORT ARM STATIC | $126.65 | $253.30 | $73.24–$230.50 | 49% below | 50% |
| Short arm splint (forearm and hand) CPT 29125 BIL APPLY FOREARM SPLINT | $416.90 | $833.80 | $241.07–$758.76 | 68% above | 50% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SPLINT SHORT ARM STATIC | $126.65 | $253.30 | $215.30–$230.50 | — | 50% |
| Short arm splint (forearm and hand) inpatient CPT 29125 BIL APPLY FOREARM SPLINT | $416.90 | $833.80 | $708.73–$758.76 | — | 50% |
| Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT | $126.65 | $253.30 | $73.24–$230.50 | 52% below | 50% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT | $126.65 | $253.30 | $215.30–$230.50 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LACRPR SMPL 2.5CM OR < SNAXGTE | $194.85 | $389.70 | $112.67–$354.63 | 47% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LACRPR SMPL 2.5CM OR < SNAXGTE | $194.85 | $389.70 | $331.24–$354.63 | — | 50% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN 1ST LESION | $667.15 | $1,334.30 | $385.78–$7,400.00 | 93% above | 50% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN 1ST LESION | $667.15 | $1,334.30 | $1,134.16–$1,214.21 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC | $211.05 | $422.10 | $122.04–$384.11 | 74% below | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC | $211.05 | $422.10 | $358.78–$384.11 | — | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LACRPR SMPL 2.6-7.5CM SNAXGTE | $207.60 | $415.20 | $120.04–$377.83 | 50% below | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LACRPR SMPL 2.6-7.5CM SNAXGTE | $207.60 | $415.20 | $352.92–$377.83 | — | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LACRPR SMPL 2.5CM OR < FEENLMM | $206.20 | $412.40 | $119.24–$375.28 | 49% below | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LACRPR SMPL 2.5CM OR < FEENLMM | $206.20 | $412.40 | $350.54–$375.28 | — | 50% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/ IMAGING | $519.30 | $1,038.60 | $300.28–$1,018.00 | 53% below | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/ IMAGING | $519.30 | $1,038.60 | $882.81–$945.13 | — | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PT 1-2 MUSCLES | $60.90 | $121.80 | $35.96–$119.36 | 88% below | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PT 1-2 MUSCLES | $60.90 | $121.80 | $103.53–$110.84 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BREAST BX W/ IMAGE | $844.30 | $1,688.60 | $488.21–$7,400.00 | 62% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BREAST BX W/ IMAGE | $844.30 | $1,688.60 | $1,435.31–$1,536.63 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN SUBQ INT 20CM | $369.40 | $738.80 | $213.60–$672.31 | 44% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN SUBQ INT 20CM | $369.40 | $738.80 | $627.98–$672.31 | — | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $527.70 | $1,055.40 | $305.14–$960.41 | 42% below | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION | $527.70 | $1,055.40 | $897.09–$960.41 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT | $88.00 | $176.00 | $50.88–$160.16 | 53% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1ST HR | $381.35 | $762.70 | $220.51–$924.00 | 38% below | 50% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1ST HR | $381.35 | $762.70 | $648.30–$694.06 | — | 50% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOGRAM | $250.45 | $500.90 | $144.82–$455.82 | 1% below | 50% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOGRAM | $250.45 | $500.90 | $425.76–$455.82 | — | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE TREATMENT | $959.65 | $1,919.30 | $554.91–$5,549.00 | 46% below | 50% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE TREATMENT | $959.65 | $1,919.30 | $1,631.40–$1,746.56 | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM | $177.30 | $354.60 | $102.52–$322.69 | 20% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM | $177.30 | $354.60 | $301.41–$322.69 | — | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT LEVEL 1 | $168.85 | $337.70 | $97.64–$1,108.00 | 5% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT VISIT LEVEL 1 | $168.85 | $337.70 | $287.04–$307.31 | — | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT LEVEL 2 | $218.10 | $436.20 | $126.12–$1,943.00 | 42% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT LEVEL 2 | $218.10 | $436.20 | $370.77–$396.94 | — | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LEVEL 3 | $267.45 | $534.90 | $154.65–$2,403.00 | 57% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LEVEL 3 | $267.45 | $534.90 | $454.66–$486.76 | — | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT LEVEL 4 | $418.65 | $837.30 | $242.08–$3,144.00 | 59% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT LEVEL 4 | $418.65 | $837.30 | $711.70–$761.94 | — | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT LEVEL 5 | $562.85 | $1,125.70 | $325.47–$4,807.00 | 62% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT LEVEL 5 | $562.85 | $1,125.70 | $956.84–$1,024.39 | — | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST | $598.05 | $1,196.10 | $345.81–$1,088.45 | 28% below | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST | $598.05 | $1,196.10 | $1,016.68–$1,088.45 | — | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY W/PATIENT 30MIN | $66.30 | $132.60 | $38.34–$120.67 | 59% below | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY W/PATIENT 1 HR | $107.20 | $214.40 | $61.98–$195.10 | 33% below | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY W/PATIENT 30MIN | $66.30 | $132.60 | $112.71–$120.67 | — | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY W/PATIENT 1 HR | $107.20 | $214.40 | $182.24–$195.10 | — | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY W/O PATIENT 1HR | $107.20 | $214.40 | $61.98–$195.10 | 32% below | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERAPY W/O PATIENT 1HR | $107.20 | $214.40 | $182.24–$195.10 | — | 50% |
| Group psychotherapy session CPT 90853 GROUP THERAPY | $134.05 | $268.10 | $77.52–$243.97 | 20% above | 50% |
| Group psychotherapy session inpatient CPT 90853 GROUP THERAPY | $134.05 | $268.10 | $227.89–$243.97 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION TX 1ST HOUR | $196.40 | $392.80 | $113.56–$357.45 | 39% below | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION TX 1ST HOUR | $196.40 | $392.80 | $333.88–$357.45 | — | 50% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION 1ST HOUR | $193.50 | $387.00 | $111.89–$352.17 | 50% below | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION 1ST HOUR | $193.50 | $387.00 | $328.95–$352.17 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ADMIN INJECTION | $70.40 | $140.80 | $40.71–$128.13 | 33% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ADMIN INJECTION | $70.40 | $140.80 | $119.68–$128.13 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 INIT EVAL/ASSESS W/O MED SERV | $210.40 | $420.80 | $121.66–$382.93 | at median | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 INIT EVAL/ASSESS W/O MED SERV | $210.40 | $420.80 | $357.68–$382.93 | — | 50% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCUL RETRAIN EA UNIT | $70.40 | $140.80 | $40.71–$408.00 | 35% below | 50% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT CHS NRMSCL RETRAIN EA UNIT | $99.00 | $198.00 | $57.24–$408.00 | 8% below | 50% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCUL RETRAIN EA UNIT | $70.40 | $140.80 | $119.68–$128.13 | — | 50% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT CHS NRMSCL RETRAIN EA UNIT | $99.00 | $198.00 | $168.30–$180.18 | — | 50% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT LVL 3 DETAILED | $123.15 | $246.30 | $71.21–$224.13 | 42% below | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT LVL 3 DETAILED | $123.15 | $246.30 | $209.36–$224.13 | — | 50% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT LVL 4 COMP MOD | $158.35 | $316.70 | $91.56–$288.20 | 44% below | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT LVL 4 COMP MOD | $158.35 | $316.70 | $269.20–$288.20 | — | 50% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT LVL 5 COMP HIGH | $193.50 | $387.00 | $111.89–$352.17 | 49% below | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT LVL 5 COMP HIGH | $193.50 | $387.00 | $328.95–$352.17 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT LVL 1 FOCUSED STRFD | $50.25 | $100.50 | $29.06–$91.46 | 66% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT LVL 2 EXP FOCUS | $88.00 | $176.00 | $50.88–$160.16 | 41% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT LVL 1 FOCUSED STRFD | $50.25 | $100.50 | $85.42–$91.46 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT LVL 2 EXP FOCUS | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNTINITIAL ASSESSEACH 15 MIN | $30.20 | $60.40 | $17.46–$54.96 | 45% below | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNTINITIAL ASSESSEACH 15 MIN | $30.20 | $60.40 | $51.34–$54.96 | — | 50% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN | $163.20 | $326.40 | $94.36–$408.00 | 36% below | 50% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN | $163.20 | $326.40 | $277.44–$297.02 | — | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT CHSEVL HIGH CMPLX 45 MIN | $342.50 | $685.00 | $198.05–$623.35 | 5% above | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT CHSEVL HIGH CMPLX 45 MIN | $342.50 | $685.00 | $582.25–$623.35 | — | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT CHS EVL LOW CMPLX 20 MIN | $342.50 | $685.00 | $198.05–$623.35 | 43% above | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT CHS EVL LOW CMPLX 20 MIN | $342.50 | $685.00 | $582.25–$623.35 | — | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT CHS EVL MOD CMPLX 30 MIN | $342.50 | $685.00 | $198.05–$623.35 | 16% above | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT CHS EVL MOD CMPLX 30 MIN | $342.50 | $685.00 | $582.25–$623.35 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY EACH 15 MIN | $88.00 | $176.00 | $50.88–$408.00 | 23% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT CHS MAN THERAPY EA UNIT | $243.15 | $486.30 | $140.60–$442.53 | 114% above | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY EACH 15 MIN | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT CHS MAN THERAPY EA UNIT | $243.15 | $486.30 | $413.36–$442.53 | — | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT EXERCISE EACH 15 MIN | $81.65 | $163.30 | $47.22–$408.00 | 18% below | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT CHS EXRCS EA UNIT | $112.25 | $224.50 | $64.91–$408.00 | 12% above | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT EXERCISE EACH 15 MIN | $81.65 | $163.30 | $138.80–$148.60 | — | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT CHS EXRCS EA UNIT | $112.25 | $224.50 | $190.82–$204.30 | — | 50% |
| Psychiatric evaluation with medical services CPT 90792 INIT EVAL/ASSESS W MED SERV | $234.55 | $469.10 | $135.62–$426.88 | 7% below | 50% |
| Psychiatric evaluation with medical services inpatient CPT 90792 INIT EVAL/ASSESS W MED SERV | $234.55 | $469.10 | $398.74–$426.88 | — | 50% |
| Psychotherapy session, 30 minutes CPT 90832 INDIVIDUAL THERAPY 16-37 MIN | $57.00 | $114.00 | $32.96–$103.74 | 64% below | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 INDIVIDUAL THERAPY 16-37 MIN | $57.00 | $114.00 | $96.90–$103.74 | — | 50% |
| Psychotherapy session, 45 minutes CPT 90834 INDIVIDUAL THERAPY 38-52 MIN | $107.20 | $214.40 | $61.98–$195.10 | 40% below | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 INDIVIDUAL THERAPY 38-52 MIN | $107.20 | $214.40 | $182.24–$195.10 | — | 50% |
| Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL THERAPY 53-67 MIN | $167.55 | $335.10 | $96.88–$304.94 | 24% below | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL THERAPY 53-67 MIN | $167.55 | $335.10 | $284.84–$304.94 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISH PT LVL 5 COMP HIGH | $218.00 | $436.00 | $126.06–$396.76 | 17% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISH PT LVL 5 COMP HIGH | $218.00 | $436.00 | $370.60–$396.76 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 FACILITY E/M FEE LEVEL lll | $14.75 | $29.50 | $8.53–$26.85 | 90% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISH PT LVL 3 EXP FOCUS | $105.60 | $211.20 | $61.06–$192.19 | 28% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 FACILITY E/M FEE LEVEL lll | $14.75 | $29.50 | $25.08–$26.85 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISH PT LVL 3 EXP FOCUS | $105.60 | $211.20 | $179.52–$192.19 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISH PT LVL 4 DETAILED | $140.75 | $281.50 | $81.39–$256.17 | 21% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISH PT LVL 4 DETAILED | $140.75 | $281.50 | $239.28–$256.17 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 FACILITY E/M FEE LEVEL ll | $11.15 | $22.30 | $6.45–$20.29 | 90% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISH PT LVL 2 FOCUS STFD | $70.40 | $140.80 | $40.71–$128.13 | 38% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 FACILITY E/M FEE LEVEL ll | $11.15 | $22.30 | $18.96–$20.29 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISH PT LVL 2 FOCUS STFD | $70.40 | $140.80 | $119.68–$128.13 | — | 50% |
| Speech and language evaluation CPT 92523 COMPREHENSIVE SPEECH LANG EVAL | $346.85 | $693.70 | $200.57–$631.27 | 9% below | 50% |
| Speech and language evaluation inpatient CPT 92523 COMPREHENSIVE SPEECH LANG EVAL | $346.85 | $693.70 | $589.64–$631.27 | — | 50% |
| Speech therapy session, individual CPT 92507 SPEECH/LANG TREATMENT | $130.15 | $260.30 | $76.84–$408.00 | 38% below | 50% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH/LANG TREATMENT | $130.15 | $260.30 | $221.26–$236.87 | — | 50% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $167.55 | $335.10 | $96.88–$304.94 | 44% below | 50% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY | $167.55 | $335.10 | $284.84–$304.94 | — | 50% |
| Spirometry before and after a bronchodilator CPT 94060 PRE & POST BRONCHODILATOR | $404.60 | $809.20 | $233.96–$736.37 | 23% below | 50% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PRE & POST BRONCHODILATOR | $404.60 | $809.20 | $687.82–$736.37 | — | 50% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT FUNCTIONAL TX EA 15 MIN | $88.00 | $176.00 | $50.88–$408.00 | 31% below | 50% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT CHS FUNC TX EA 15 MIN | $115.25 | $230.50 | $66.64–$408.00 | 9% below | 50% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT FUNCTIONAL TX EA 15 MIN | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT CHS FUNC TX EA 15 MIN | $115.25 | $230.50 | $195.92–$209.76 | — | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPUETIC | $112.00 | $224.00 | $64.76–$203.84 | 46% below | 50% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPUETIC | $112.00 | $224.00 | $190.40–$203.84 | — | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACC 0.5ML SYR | $21.73 | $43.45 | $12.56–$39.54 | 38% below | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACC 0.5ML SYR | $21.73 | $43.45 | $36.93–$39.54 | — | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE HD 0.5 ML | $35.00 | $69.99 | $20.24–$63.69 | 48% below | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VACCINE HD 0.5 ML | $35.00 | $69.99 | $59.49–$63.69 | — | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 VALENT CONJ DIP CRM PF 0.5 ML SYRI | $314.48 | $628.95 | $181.84–$572.34 | 12% below | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 VALENT CONJ DIP CRM PF 0.5 ML SYRI | $314.48 | $628.95 | $534.61–$572.34 | — | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL PPSV23 VACC | $105.00 | $210.00 | $60.71–$191.10 | 36% below | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL PPSV23 VACC | $105.00 | $210.00 | $178.50–$191.10 | — | 50% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE IMOVAX 2.5 UNITS VIAL | $314.48 | $628.95 | $181.84–$572.34 | 58% below | 50% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IMOVAX 2.5 UNITS VIAL | $314.48 | $628.95 | $534.61–$572.34 | — | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPHTHERIA TOXOIDS ADSORB 0.5 ML SYRINGE | $50.57 | $101.14 | $29.24–$92.04 | 34% below | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIPHTHERIA TOXOIDS ADSORB 0.5 ML SYRINGE | $50.57 | $101.14 | $85.97–$92.04 | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETDIPHPERTUSSIS 0.5 ML | $47.50 | $95.00 | $27.47–$86.45 | 54% below | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUSDIPHTHERIAAC PERTUSSIS ADULT 0.5 ML ADACEL | $55.21 | $110.42 | $31.93–$100.48 | 46% below | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETDIPHPERTUSSIS 0.5 ML | $47.50 | $95.00 | $80.75–$86.45 | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUSDIPHTHERIAAC PERTUSSIS ADULT 0.5 ML ADACEL | $55.21 | $110.42 | $93.86–$100.48 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU VACCINE INJECTION ADMIN | $56.55 | $113.10 | $32.70–$102.92 | at median | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HEPATITIS B VACCINE INJ ADMIN | $72.80 | $145.60 | $42.10–$132.50 | 29% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMONIA VACCINE INJ ADMIN | $87.70 | $175.40 | $50.71–$159.61 | 56% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION | $88.00 | $176.00 | $50.88–$160.16 | 56% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 FLU VACCINE INJECTION ADMIN | $56.55 | $113.10 | $96.14–$102.92 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HEPATITIS B VACCINE INJ ADMIN | $72.80 | $145.60 | $123.76–$132.50 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PNEUMONIA VACCINE INJ ADMIN | $87.70 | $175.40 | $149.09–$159.61 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION | $88.00 | $176.00 | $149.60–$160.16 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EACH ADD'L VACCINE ADMIN | $63.20 | $126.40 | $36.54–$115.02 | 64% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 EACH ADD'L VACCINE ADMIN | $63.20 | $126.40 | $107.44–$115.02 | — | 50% |
Source file: https://stauntonhospital.org/wp-content/uploads/2026/04/370624255_anderson_healthcare_standardcharges.csv